Artykuły w czasopismach na temat „Newborn infants – Death”
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Cochran-Black, Diana L., Linda D. Cowan i Barbara R. Neas. "The Relation Between Newborn Hemoglobin F Fractions and Risk Factors for Sudden Infant Death Syndrome". Archives of Pathology & Laboratory Medicine 125, nr 2 (1.02.2001): 211–17. http://dx.doi.org/10.5858/2001-125-0211-trbnhf.
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Abstract Objectives.—The aims of this study were to determine and compare fetal hemoglobin (HbF) fractions at birth in newborns exposed and not exposed to selected factors that have been reported to increase the risk of sudden infant death syndrome (SIDS). Previous studies have implicated HbF in the etiology of SIDS by finding higher fractions in infants dying from SIDS compared to age-matched control infants. Design.—We performed a cross-sectional study using high-performance liquid chromatography to measure HbF fractions in newborn cord blood samples. Exposure to selected risk factors for SIDS was assessed through review of medical records. Participants.—Six hundred thirty-three infants born at Via Christi Regional Medical Center–St Francis Campus, Wichita, Kan, from February 28 through August 5, 1997. Main Outcome Measure.—Hemoglobin F fractions at birth were compared in newborns exposed and not exposed to selected risk factors associated with increased incidence of SIDS. Results.—Mean HbF fractions were significantly higher in preterm newborns of mothers who smoked and in term newborns with intrauterine growth restriction, pregnancy weight gain less than or equal to 9 kg, and pregnancy complications associated with reduced placental blood flow. An elevated newborn HbF fraction, defined as 77% or greater, was significantly associated with maternal smoking, maternal anemia, intrauterine growth restriction, and pregnancy complications associated with reduced placental blood flow. Conclusion.—This study suggests a possible mechanism (HbF) by which previously identified factors may increase the risk of SIDS.
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Liamputtong, Pranee. "Childrearing Practices and Child Health among the Hmong in Australia: Implications for Health Services". International Journal of Health Services 32, nr 4 (październik 2002): 817–36. http://dx.doi.org/10.2190/ttlq-yc48-gtvq-3djh.
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This study of cultural beliefs and practices related to childrearing and child health among the Hmong in Melbourne, Australia, used in-depth interviews and participant observation of 27 Hmong mothers and some Hmong traditional healers between 1993 and 1998. Traditional Hmong beliefs and practices include: taking notice of the birth date and time, placing a silver necklace on the newborn, not praising the newborn, not taking the infant out during the first 30 days, breastfeeding, the infant's sharing a bed with the parents, and a soul-calling ceremony on the third day after birth. All Hmong mothers follow cultural beliefs and practices to prevent the ill-health or death of their newborn infants, but some aspects of these practices have had to be modified to suit the new living environment in Australia. Health care professionals need to acknowledge the different ways of caring for a young child among the Hmong so as to avoid misunderstandings and to provide sensitive care. Hmong beliefs and practices also have implications for health promotion campaigns and can be a valuable source of ideas in the efforts to promote infant health and reduce infant deaths in Australia and elsewhere.
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Finster, Mieczyslaw, Margaret Wood i Srinivasa N. Raja. "The Apgar Score Has Survived the Test of Time". Anesthesiology 102, nr 4 (1.04.2005): 855–57. http://dx.doi.org/10.1097/00000542-200504000-00022.
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In 1953, Virginia Apgar, M.D. published her proposal for a new method of evaluation of the newborn infant. The avowed purpose of this paper was to establish a simple and clear classification of newborn infants which can be used to compare the results of obstetric practices, types of maternal pain relief and the results of resuscitation. Having considered several objective signs pertaining to the condition of the infant at birth she selected five that could be evaluated and taught to the delivery room personnel without difficulty. These signs were heart rate, respiratory effort, reflex irritability, muscle tone and color. Sixty seconds after the complete birth of the baby a rating of zero, one or two was given to each sign, depending on whether it was absent or present. Virginia Apgar reviewed anesthesia records of 1025 infants born alive at Columbia Presbyterian Medical Center during the period of this report. All had been rated by her method. Infants in poor condition scored 0-2, infants in fair condition scored 3-7, while scores 8-10 were achieved by infants in good condition. The most favorable score 1 min after birth was obtained by infants delivered vaginally with the occiput the presenting part (average 8.4). Newborns delivered by version and breech extraction had the lowest score (average 6.3). Infants delivered by cesarean section were more vigorous (average score 8.0) when spinal was the method of anesthesia versus an average score of 5.0 when general anesthesia was used. Correlating the 60 s score with neonatal mortality, Virginia found that mature infants receiving 0, 1 or 2 scores had a neonatal death rate of 14%; those scoring 3, 4, 5, 6 or 7 had a death rate of 1.1%; and those in the 8-10 score group had a death rate of 0.13%. She concluded that the prognosis of an infant is excellent if he receives one of the upper three scores, and poor if one of the lowest three scores.
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Zhang, Stephanie Q., Hayley Friedman i Marya L. Strand. "Length of Resuscitation for Severely Depressed Newborns". American Journal of Perinatology 37, nr 09 (5.06.2019): 933–38. http://dx.doi.org/10.1055/s-0039-1692181.
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Objective Current guidelines for neonatal resuscitation suggest it may be reasonable to stop resuscitation after 10 minutes in infants born with no detectable heartbeat. This study describes the length of resuscitation provided in a cohort of profoundly compromised newborn infants. Study Design Chart review of a regional hospital system database of newborn infants from 2010 to 2017 with a documented 10-minute Apgar score of 0 or 1. Results From a total birth population of 49,876 infants, 172 newborns were identified. Of these, 133 infants did not receive resuscitation and died while receiving comfort care. In the 39 resuscitated infants, 15 (38%) achieved return of spontaneous circulation (ROSC) at an average of 20 minutes; 32 of these 39 newborns (82%) died within 24 hours. Average time to ROSC for survivors was 17.8 minutes. Death or severe neurologic disability at 15 to 24 months of age was present in 92% (36/39) of resuscitated infants. Conclusion Prolonged resuscitation of newborns is rare. In this cohort, 92% died or had severe neurodevelopmental disability. Infants with ROSC received 20 minutes of resuscitation. Infants with ROSC typically did not survive beyond 24 hours unless they survived to discharge. To increase the number of infants with ROSC, continuing resuscitation beyond 10 minutes may be reasonable.
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Zarubin, A. A., E. S. Filippov, A. S. Vanyarkina, O. G. Ivanova i A. A. Shishkina. "Comparison of Uncontrolled and Device-Induced Therapeutic Hypothermia in Newborn Infants with Hypoxic Ischemic Encephalopathy". Acta Biomedica Scientifica 6, nr 1 (10.04.2021): 88–93. http://dx.doi.org/10.29413/abs.2021-6.1.13.
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Background. Newborn infants who have undergone severe birth asphyxia have a high risk of neurological disorders and death. The most effective method for the treatment of hypoxic ischemic encephalopathy caused by intrapartum asphyxia is therapeutic hypothermia, or targeted temperature management. Currently, there are no large studies comparing its different methods, therefore the aim of our study was to compare the effectiveness of device-induced and uncontrolled therapeutic hypothermia in newborn infants who underwent intrapartum asphyxia.Materials and methods. Study design: we conducted a retrospective, longitudinal, cohort study in 39 newborn infants born in severe asphyxia and receiving uncontrolled therapeutic hypothermia (group 1), and in 48 newborn infants born in severe asphyxia and receiving device-induced therapeutic hypothermia (group 2). Statistical data processing was carried out using standard techniques.Results. The body temperature in newborn infants of both groups was reduced to 33.5 °C within the first hour, but when using uncontrolled therapeutic hypothermia, the body temperature fluctuated from 32 to 35 °C. Device-induced therapeutic hypothermia has a more effective neuroprotective effect as compared to uncontrolled hypothermia (p< 0.05) and more rapidly stabilizes metabolism in newborns due to a decrease in lactate levels (p < 0.05). In newborns device-induced therapeutic hypothermia stabilizes hemodynamics more quickly compared to uncontrolled therapeutic hypothermia (p < 0.05). Device-induced therapeutic hypothermia reduces the period of hospitalization in the neonatal intensive care unit (p < 0.05), the risk of cerebral edema (p < 0.05) and of the repeated episodes of seizures (p < 0.05). Conclusion. Using uncontrolled therapeutic hypothermia causes a high risk of unintentional fluctuations in rectal temperature towards both hypothermia and rewarming, which can aggravate the severe condition of newborn infants. Device-induced therapeutic hypothermia has a more effective neuroprotective effect.
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Putra, Putu Junara. "Characteristics and outcomes of low birth weight infants in Bali". Paediatrica Indonesiana 52, nr 5 (31.10.2012): 300. http://dx.doi.org/10.14238/pi52.5.2012.300-3.
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Background The prevalence and the mortality of low birthweight infants are still high. Low birth weight (LBW) births areresponsible for newborn death. LBW infants are easier to sufferserious health problems and death. Lower infant body weightand younger gestational age are determinants of greater risk ofmortality.Objective To determine the characteristics of LBW infants andtheir outcomes in Sanglah Hospital, Denpasar.Methods This prospective study was conducted on all LBWinfants in the nursery from their time of admission until dischargefor the year of 20 11..Results There were 120 LBW infants admitted to SanglahHospital fromJanuary 2011 to December 2011. The prevalenceofLBW was 8.9%. The birth weight group of 15002499 gramshad the highest number of infants (79.2%). The gestational agegroup of 3336 weeks had 53.3% of the infants, while 68.3% ofthe LBW infants were of the appropriate gestational age. Themost common method of delivery was normal spontaneousdelivery (70%). Moderate asphyxia was observed in 25% of thesubjects, while severe asphyxia was observed in 22.5% of subjects.The mortality rate was 24.2%.Conclusions The prevalence of LBW of all newborns in ourhospital was 8.9%. Severe asphyxia was observed in 22.5% ofsubjects. The mortality rate of the LBW infants was 24.2%. OurLBW infants were most cormnonly in the categories of birth weightof 15002499 grams, gestational age was between 3336 weeks,appropriate for gestational age, as well as delivered spontaneously.[Paediatr lndanes. 2012,52:30003].
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Raha-Chowdhury, R., C. A. Moore, D. Bradley, R. Henley i M. Worwood. "Blood ferritin concentrations in newborn infants and the sudden infant death syndrome." Journal of Clinical Pathology 49, nr 2 (1.02.1996): 168–70. http://dx.doi.org/10.1136/jcp.49.2.168.
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Breathnach, Ciara, i Eunan O’Halpin. "Registered ‘unknown’ infant fatalities in Ireland, 1916–32: gender and power". Irish Historical Studies 38, nr 149 (maj 2012): 70–88. http://dx.doi.org/10.1017/s0021121400000638.
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The phenomenon of ‘unknown’ infant deaths addressed in this article was first explored in the course of research on fatalities arising from political violence during the Irish revolution of 1916–1921. Our data are derived from the General Register of Death Indices (G.R.D.I.), held in the General Register Office, Dublin, which are organised alphabetically, and which form an official record of deaths registered either by relatives of the deceased or by medical personnel. When infant ‘unknown’ fatalities were extracted to form a discrete database they showed a curious gender disparity. There were 100 male infant fatalities recorded for every seventy-eight females in the thirty-two counties over the five-year period. On extending the study to 1932, the same ratio was prevalent in the overall dataset of 895 ‘unknown infants’ drawn from the G.R.D.I. (a dataset which excludes the six counties of Northern Ireland for the period from1922). Initial research into the gender imbalance opened out wider questions concerning social mores regarding illegitimacy, and the extent of medical and lay knowledge of how newborn infants might be brought to death.
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Chaves, Luciano Eustáquio, i Luiz Fernando C. Nascimento. "Estimating outcomes in newborn infants using fuzzy logic". Revista Paulista de Pediatria 32, nr 2 (czerwiec 2014): 164–70. http://dx.doi.org/10.1590/0103-058220143228413.
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OBJECTIVE: To build a linguistic model using the properties of fuzzy logic to estimate the risk of death of neonates admitted to a Neonatal Intensive Care Unit.METHODS: Computational model using fuzzy logic. The input variables of the model were birth weight, gestational age, 5th-minute Apgar score and inspired fraction of oxygen in newborn infants admitted to a Neonatal Intensive Care Unit of Taubaté, Southeast Brazil. The output variable was the risk of death, estimated as a percentage. Three membership functions related to birth weight, gestational age and 5th-minute Apgar score were built, as well as two functions related to the inspired fraction of oxygen; the risk presented five membership functions. The model was developed using the Mandani inference by means of Matlab(r) software. The model values were compared with those provided by experts and their performance was estimated by ROC curve.RESULTS: 100 newborns were included, and eight of them died. The model estimated an average possibility of death of 49.7±29.3%, and the possibility of hospital discharge was 24±17.5%. These values are different when compared by Student's t-test (p<0.001). The correlation test revealed r=0.80 and the performance of the model was 81.9%.CONCLUSIONS: This predictive, non-invasive and low cost model showed a good accuracy and can be applied in neonatal care, given the easiness of its use.
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Chace, Donald H., James C. DiPerna, Brenda L. Mitchell, Bethany Sgroi, Lindsay F. Hofman i Edwin W. Naylor. "Electrospray Tandem Mass Spectrometry for Analysis of Acylcarnitines in Dried Postmortem Blood Specimens Collected at Autopsy from Infants with Unexplained Cause of Death". Clinical Chemistry 47, nr 7 (1.07.2001): 1166–82. http://dx.doi.org/10.1093/clinchem/47.7.1166.
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Abstract Background: Deaths from inherited metabolic disorders may remain undiagnosed after postmortem examination and may be classified as sudden infant death syndrome. Tandem mass spectrometry (MS/MS) may reveal disorders of fatty acid oxidation in deaths of previously unknown cause. Methods: We obtained filter-paper blood from 7058 infants from United States and Canadian Medical Examiners. Acylcarnitine and amino acid profiles were obtained by MS/MS. Specialized interpretation was used to evaluate profiles for disorders of fatty acid, organic acid, and amino acid metabolism. The analyses of postmortem blood specimens were compared with the analyses of bile specimens, newborn blood specimens, and specimens obtained from older infants at risk for metabolic disorders. Results: Results on 66 specimens suggested diagnoses of metabolic disorders. The most frequently detected disorders were medium-chain and very-long-chain acyl-CoA dehydrogenase deficiencies (23 and 9 cases, respectively), glutaric acidemia type I and II deficiencies (3 and 8 cases, respectively), carnitine palmitoyl transferase type II/translocase deficiencies (6 cases), severe carnitine deficiency (4 cases), isovaleric acidemia/2-methylbutyryl-CoA dehydrogenase deficiencies (4 cases), and long-chain hydroxyacyl-CoA dehydrogenase/trifunctional protein deficiencies (4 cases). Conclusions: Postmortem metabolic screening can explain deaths in infants and children and provide estimates of the number of infant deaths attributable to inborn errors of metabolism. MS/MS is cost-effective for analysis of postmortem specimens and should be considered for routine use by Medical Examiners and pathologists in unexpected/unknown infant and child death.
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Wang, Raymond Y. "A Newborn Screening, Presymptomatically Identified Infant With Late-Onset Pompe Disease: Case Report, Parental Experience, and Recommendations". International Journal of Neonatal Screening 6, nr 1 (14.03.2020): 22. http://dx.doi.org/10.3390/ijns6010022.
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Pompe disease is an inherited lysosomal storage disorder caused by acid alpha-glucosidase (GAA) enzyme deficiency, resulting in muscle and neuron intralysosomal glycogen storage. Clinical symptoms vary from the severe, infantile-onset form with hypertrophic cardiomyopathy, gross motor delay, and early death from respiratory insufficiency; to a late-onset form with variable onset of proximal muscle weakness and progressive respiratory insufficiency. Newborn screening programs have been instituted to presymptomatically identify neonates with infantile-onset Pompe disease for early initiation of treatment. However, infants with late-onset Pompe disease are also identified, leaving families and physicians in a state of uncertainty regarding prognosis, necessity, and timing of treatment initiation. This report presents a 31 5/7 weeks’ gestational age premature infant flagged positive for Pompe disease with low dried blood spot GAA activity; sequencing identified biparental c.-32-13T>G/c.29delA GAA variants predicting late-onset Pompe disease. The infant’s parents’ initial reactions to the positive newborn screen, subsequent experience during confirmatory testing, and post-confirmation reflections are also reported. While uncertainties regarding natural history and prognosis of presymptomatically-identified late-onset Pompe disease infants will be elucidated with additional experience, suggestions for education of first-line providers are provided to accurately communicate results and compassionately counsel families regarding anxiety-provoking positive newborn screen results.
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S., Srinivasa, Anjum Aara C. A. i Pavan Kumar Kalla. "Postnatal foot length of newborn: its correlation with gestational maturity". International Journal of Contemporary Pediatrics 7, nr 7 (24.06.2020): 1614. http://dx.doi.org/10.18203/2349-3291.ijcp20202626.
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Background: Neonatal death is one of the major contributors (50%) of Under-five child mortality and 70% of the infant mortality. The main causes of neonatal deaths are prematurity and low birth weight (LBW). This study was undertaken to assess newborn foot length and determine its usefulness in identifying LBW/Preterm Babies.Methods: This is a cross sectional hospital based study of 173 newborn babies, done in KIMS Hospital, Bengaluru. All live newborn infants were included in the study. Newborn babies with lower limb congenital anomalies were excluded from the study.Results: Out of 173 newborn, 99 babies were male (57%) and 74 were female (43%). 122 (70.5%) were term and 51(29.5%) were preterm. 48 (38%) were SGA, 120 (69%) were AGA and 5 (3%) were LGA. Their gestational age ranged from 28 to 40 weeks. In this study positive Correlation between foot length and gestational age was found with the “r” value of 0.823. The study also showed a positive correlation between foot length and weight with the “r” value of 0.831.Conclusions: This study has a good correlation of Foot length with gestational maturity and birth weight. Foot length of 7.45cm can be used as a cut- off point for differentiating between term and preterm babies. Derived equation from this study can be used by ASHAs and Anganwadi workers for the estimation of gestational age in resource poor situations and refer the preterm newborns to higher centres for further management as early as possible to prevent long and short term complications of prematurity.
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Yeh, Jennifer, Natasha K. Stout, Aeysha Chaudhry, Michael Gooch, Pamela McMahon, Kurt D. Christensen, Lisa Diller i Ann C. Wu. "Population-based cancer predisposition testing as a component of newborn screening: A cost-effectiveness analysis." Journal of Clinical Oncology 37, nr 15_suppl (20.05.2019): 10021. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.10021.
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10021 Background: The role of population-based newborn genetic testing to identify infants at high risk of childhood-onset cancers has not been studied, despite the availability of cancer surveillance guidelines for early detection in high-risk infants and children. Methods: We developed the Precision Medicine Prevention and Treatment (PreEMPT) Model to estimate the value of targeted population-based newborn genomic sequencing (tNBS) for a select panel of genes associated with early onset pediatric malignancy. Cohorts of US newborns were simulated under tNBS screening vs. usual care, from birth to death. Six pediatric cancer predisposition syndromes were included in the model with mutations in RET, RB1, TP53, DICER1, SUFU or SMARCB1 assigned at birth, using mutation prevalence and disease risks drawn from the published literature, as well as SEER, ClinVar and gnoMAD databases. Newborns with mutations underwent cancer surveillance based on established guidelines for each gene-related pediatric malignancy. Survival benefit was modeled as a reduction in proportion of advanced disease, cancer deaths, and treatment-related late mortality risks. Costs were based on published literature and national databases. Results: In a typical US birth cohort of 4 million newborns, we estimated 1280 cancer cases in the malignancies associated with this gene panel would be detected before age 20 under usual care, resulting in 451 cancer deaths and 490 living with radiation exposure risks. tNBS would prevent 8 cancers (in RET mutation carriers), avert 34 deaths through surveillance, result in 3190 life-years (LY) gained and a 13% relative reduction in proportion of adult survivors at risk for radiation-associated late mortality. Given a sequencing cost of $30 (e.g., $5/gene), the incremental cost-effectiveness ratio (ICER) for tNBS was $230,500 per LY saved; if no additional cost was incurred beyond standard newborn screening, the ICER decreased to $101,100/LY. Conclusions: Population-based genetic testing of newborns can reduce mortality associated with pediatric cancers and could potentially be cost-effective as sequencing costs decline. Further work will include modeling a broader panel of predisposition genes.
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Parti, Sumiati Malik i Nurhayati. "Pengaruh Perawatan Metode Kanguru (PMK) terhadap Pencegahan Hipotermi pada Bayi Baru Lahir". Jurnal Bidan Cerdas 2, nr 2 (27.05.2020): 66–71. http://dx.doi.org/10.33860/jbc.v2i2.56.
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Most causes of infant death are problems that occur in newborn/neonatal (0-28 days old), Low Birth Weight Babies (LBW) is one of the factors which has a contribution to infant mortality, especially in the neonatal period. Infant Mortality Rate (IMR) is a benchmark in determining the degree of public health, both at the National and Provincial levels. This study aimed to determine the effect of the Kangaroo Mother Care Method (KMC) on the prevention of hypothermia in low birth weight infants at Morowali District Hospital in 2019. The type of research used was a quasi-experiment. The population is all low birth weight babies born from May to July 2019. The sample in this study was all newborns with low birth weight born from May to July 2019, totaling 30 babies. There is a difference (influence) on the baby's body temperature before and after KMC with a p-value=0,000. The kangaroo mother care can continue to be affiliated considering its benefits for both infants and mothers, as well as increasing the ability of health workers in conducting KMC so that they can provide in-house training for mothers to be carried out at home.
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Bahtera, Tjipta, Santoso Suroso i Bambang Darmanto. "Neurological Sequalae in Survivors of Perinatal Asphyxia". Paediatrica Indonesiana 32, nr 7-8 (30.01.2019): 169–77. http://dx.doi.org/10.14238/pi32.7-8.1992.169-77.
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Perinatal asphyxia is the most common cause of either death or severely handicapped survivors. Perinatal asphyxia can be identified by one, five, ten minutes APGAR scores less than 7. Prolonged asphyxia produce hypoxemia, acidosis, hypercapnia, thus diminishing cerebral blood flow, which in turn results in clinical patterns of Hypoxic - Ischemic Encephalopathy (HIE). The atm of this study was to evaluate the accuracy of clinical observation on newborn asphyxia to predict the presence of neurological deficits connected with blood gas analysts investigation. Thirty eight newborn babies who bad APGAR scores of less than 7 as an asphyctic newborn baby group compared with an equal number of normal babies as control group. Physical and neurological examinations were performed immediately after birth and at six months of age. Two of the 38 infants who bad perinatal asphyxia died several hours after birth. Two of the 31 of the surviving infants with a historical of perinatal asphyxia bad cerebral palsy. One of the two babies with cerebral palsy bad epilepsy. Twenty nine of the 31 of the surviving infants with a history of perinatal asphyxia with or without mild HIE showed normal neurological outcomes. All of the normal newborn babies as control showed normal neurological outcome. One infant with cerebral palsy and one infant who bad cerebral palsy with epilepsy bad a history of a severe degree of HIE and moderate degree of Hm with neonatal convulsion respectively. One of the 2 infants with cerebral palsy bad severe hypoxia and none on the infants with normal neurological outcome exhibited Pa02 less than 50 mmHg. There were no significant differences ( p > 0.05) of the Pa02 PH and base deficit between the infants with a history of asphyxia and with a history of a vigorous baby, who bad a normal outcome.
We concluded that postasphyxia encephalopathy was more accurate than a low APGAR score in predicting an adverse outcome, and the value of the Pa02 very important in predicting an encephalopathy.
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Deguen, Séverine, Guadalupe Perez Marchetta i Wahida Kihal-Talantikite. "Measuring Burden of Disease Attributable to Air Pollution Due to Preterm Birth Complications and Infant Death in Paris Using Disability-Adjusted Life Years (DALYs)". International Journal of Environmental Research and Public Health 17, nr 21 (26.10.2020): 7841. http://dx.doi.org/10.3390/ijerph17217841.
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Several studies have found maternal exposure to particulate matter pollution was associated with adverse birth outcomes, including infant mortality and preterm birth. In this context, our study aims to quantify the air pollution burden of disease due to preterm birth complications and infant death in Paris, with particular attention to people living in the most deprived census blocks. Data on infant death and preterm birth was available from the birth and death certificates. The postal address of mother’s newborn was converted in census block number. A socioeconomic deprivation index was built at the census block level. Average annual ambient concentrations of PM10 were modelled at census block level using the ESMERALDA atmospheric modelling system. The number of infant deaths attributed to PM10 exposure is expressed in years of life lost. We used a three-step compartmental model to appraise neurodevelopmental impairment among survivors of preterm birth. We estimated that 12.8 infant deaths per 100,000 live births may be attributable to PM10 exposure, and about one third of these infants lived in deprived census blocks. In addition, we found that approximately 4.8% of preterm births could be attributable to PM10 exposure, and approximately 1.9% of these infants died (corresponding to about 5.75 deaths per 100,000 live birth). Quantification of environmental hazard-related health impacts for children at local level is essential to prioritizing interventions. Our study suggests that additional effort is needed to reduce the risk of complications and deaths related to air pollution exposure, especially among preterm births. Because of widespread exposure to air pollution, significant health benefits could be achieved through regulatory interventions aimed at reducing exposure of the population as a whole, and particularly of the most vulnerable, such as children and pregnant women.
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Ebela, Inguna, Irisa Zile, Aleksandrs Zakis, Valdis Folkmanis i Ingrida Rumba-Rozenfelde. "Mortality of Children Under Five and Prevalence of Newborn Congenital Anomalies in Relation to Macroeconomic and Socioeconomic Factors in Latvia". Medicina 47, nr 12 (3.01.2012): 98. http://dx.doi.org/10.3390/medicina47120098.
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Background. Mortality of infants and children younger than 5 years is a globally recognized and broad national welfare indicator. Scientific literature has data on the correlation of mortality indicators with macroeconomic indicators. It is important to study the associations between prevalence and mortality indicators and socioeconomic factors, since deaths from congenital anomalies account for approximately 25%–30% of all deaths in infancy. The aim of the study was to analyze the overall trend in mortality of infants and young children aged 0 to 4 years in relation to macroeconomic factors in Latvia and prevalence of congenital anomalies in newborns in relation to socioeconomic factors. Material and Methods. The Newborns’ Register and Causes of Death Register were used as data sources; data on specific socioeconomic factors were retrieved from the Central Statistics Office. Results. The results of the study show a strong correlation between mortality in children younger than 5 years and gross domestic product, as well as health budget in LVL per capita and the national unemployment level. The average decrease in infant mortality from congenital anomalies in Latvia was found to be 6.8 cases per 100 000 live births. Conclusions. There is a strong correlation between child mortality and socioeconomic situation in the country. There is a need to analyze the data on child mortality in a transnational context on a regular basis and studying the correlations between child mortality indicators and socioeconomic indicators and health care management parameters.
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Perrone, Serafina, Chiara Lembo, Sabrina Moretti, Giovanni Prezioso, Giuseppe Buonocore, Giorgia Toscani, Francesca Marinelli, Francesco Nonnis-Marzano i Susanna Esposito. "Sudden Infant Death Syndrome: Beyond Risk Factors". Life 11, nr 3 (26.02.2021): 184. http://dx.doi.org/10.3390/life11030184.
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Sudden infant death syndrome (SIDS) is defined as “the sudden death of an infant under 1 year of age which remains unexplained after thorough investigation including a complete autopsy, death scene investigation, and detailed clinical and pathological review”. A significant decrease of SIDS deaths occurred in the last decades in most countries after the beginning of national campaigns, mainly as a consequence of the implementation of risk reduction action mostly concentrating on the improvement of sleep conditions. Nevertheless, infant mortality from SIDS still remains unacceptably high. There is an urgent need to get insight into previously unexplored aspects of the brain system with a special focus on high-risk groups. SIDS pathogenesis is associated with a multifactorial condition that comprehends genetic, environmental and sociocultural factors. Effective prevention of SIDS requires multiple interventions from different fields. Developing brain susceptibility, intrinsic vulnerability and early identification of infants with high risk of SIDS represents a challenge. Progress in SIDS research appears to be fundamental to the ultimate aim of eradicating SIDS deaths. A complex model that combines different risk factor data from biomarkers and omic analysis may represent a tool to identify a SIDS risk profile in newborn settings. If high risk is detected, the infant may be referred for further investigations and follow ups. This review aims to illustrate the most recent discoveries from different fields, analyzing the neuroanatomical, genetic, metabolic, proteomic, environmental and sociocultural aspects related to SIDS.
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Nuryanti Zulala, Nuli, Mei Neni Sitaresmi i Sulistyaningsih. "INISIASI MENYUSU DINI MENJAGA KESTABILAN SUHU PADA BAYI BARU LAHIR". MEDIA ILMU KESEHATAN 7, nr 1 (17.11.2019): 51–59. http://dx.doi.org/10.30989/mik.v7i1.222.
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Background: Hypothermia contributes 6.3% to neonatal mortality. Interventions to keep newborns warm can reduce neonatal mortality by 18-42%. Early Breastfeeding Initiation (EBI) is a simple intervention that reduces the risk of neonatal death.
Objective: The aim of this study to determine the difference of axillary temperature of newborn between improper EBI group and proper EBI group for 24 hours.
Methods: This prospective cohort study was conducted at Aisyiyah Muntilan Hospital. Sixty-two healthy newborns from healthy mothers born in November 2016 who meet the inclusion and exclusion criteria. Subjects were grouped in improper EBI groups (n=32) and proper EBI groups (n=32). Axila temperature measurements were performed at 1st minute, 30th minute, 60th minute, 6th hour, 12th hour, 24th hour.
Results: The result of the hypotermic occurrence is more happened on improper EBI than proper EBI. EBI is able to prevent hypothermia during the first 24 hours of newborn life
Conclussions: Infants with proper EBI have a lower risk of hypothermia.
Keyword: Early Breastfeeding Initiation, Hypothermia, Newborn
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Akhmina, N. I., A. V. Nikopol’skaya, E. M. Bragina, O. N. Zhdanova i Zh L. Chabaidze. "Anhidrotic ectodermal dysplasia in a newborn: case history". Russian Journal of Woman and Child Health 3, nr 4 (2020): 340–43. http://dx.doi.org/10.32364/2618-8430-2020-3-4-340-343.
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The article describes step-by-step diagnostic approach for identifying the cause of fever in a newborn: from excluding infections and noninfectious factors provoking impaired thermoregulation to the diagnosis of a rare congenital disorder, anhidrotic ectodermal dysplasia (EDA) confirmed by genetic testing. EDA is a hereditary condition caused by mutations in the EDA gene encoding prenatal development of ectodermal derivatives. The main phenotypic signs of EDA are aplasia (hypoplasia) of sweat glands, dysplasia of skin and its appendages (hypotrichosis, nail hypoplasia etc.), and hypodontia. Hypoplasia or aplasia of the sweat glands results in impaired thermoregulation and, therefore, hyperthermia. Since hair and dental dysplasia do not manifest in newborns, EDA is commonly missed in newborns and diagnosed lately. Fever is one of the dangerous manifestations of EDA that, in tight swaddling, may result in death. Nonspecific clinical presentations of EDA in newborns require consultations with other specialists. Recognition of EDA clinical signs in newborns and infants (craniofacial dysmorphism, thin and dry skin, periorbital hyperpigmentation, reduction in body temperature after external cooling observed in the child) allows for early diagnosis and determines cooling strategy and further lifestyle. KEYWORDS: newborn, hyperthermia, anhidrotic ectodermal dysplasia, fever in newborns, differential diagnosis, causes of fever, molecular genetic testing. FOR CITATION: Akhmina N.I., Nikopol’skaya A.V., Bragina E.M. et al. Anhidrotic ectodermal dysplasia in a newborn: case history. Russian Journal of Woman and Child Health. 2020;3(4):340–343. DOI: 10.32364/2618-8430-2020-3-4-340-343.
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Zulala, Nuli Nuryanti, Mei Neni Sitaresmi i Sulistyaningsih Sulistyaningsih. "INISIASI MENYUSU DINI MENJAGA KESTABILAN SUHU PADA BAYI BARU LAHIR". Media Ilmu Kesehatan 7, nr 1 (30.04.2018): 51–59. http://dx.doi.org/10.30989/mik.v7i1.267.
Pełny tekst źródłaStreszczenie:
Background: Hypothermia contributes 6.3% to neonatal mortality. Interventions to keep newborns warm can reduce neonatal mortality by 18-42%. Early Breastfeeding Initiation (EBI) is a simple intervention that reduces the risk of neonatal death.
Objective: The aim of this study to determine the difference of axillary temperature of newborn between improper EBI group and proper EBI group for 24 hours.
Methods: This prospective cohort study was conducted at Aisyiyah Muntilan Hospital. Sixty-two healthy newborns from healthy mothers born in November 2016 who meet the inclusion and exclusion criteria. Subjects were grouped in improper EBI groups (n=32) and proper EBI groups (n=32). Axila temperature measurements were performed at 1st minute, 30th minute, 60th minute, 6th hour, 12th hour, 24th hour.
Results: The result of the hypotermic occurrence is more happened on improper EBI than proper EBI. EBI is able to prevent hypothermia during the first 24 hours of newborn life
Conclussions: Infants with proper EBI have a lower risk of hypothermia.
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Krebs, Vera Lúcia Jornada, i Gleise Aparecida Moraes Costa. "Clinical outcome of neonatal bacterial meningitis according to birth weight". Arquivos de Neuro-Psiquiatria 65, nr 4b (grudzień 2007): 1149–53. http://dx.doi.org/10.1590/s0004-282x2007000700011.
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OBJECTIVE: To describe the clinical outcome and the complications of bacterial meningitis according to birth weight of out born neonates admitted in intensive care unit during an 11 year-period. METHOD: Eighty-seven newborns were studied. Thirty-four infants were low birth weight newborn and 53 presented birth weight > " 2500 g. The clinical data were obtained through the analysis of patients’ files. Fisher’s exact test, the c² and the Mann-Whitney test were applied. RESULTS: Neurological symptoms were more common in infants weighed > " 2500 g (p<0.05). Complications affected half of the cases in both groups. Complications affected half of the cases in both groups, with an overall mortality rate of 11.5%. CONCLUSION: The rate of complications was high in both groups, regardless of the birth weight. No association was observed between the occurrence of death and birth weight. Infants with positive CSF culture had a poorer prognosis.
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Kaku, Noriyuki, Kenji Ihara, Yuichiro Hirata, Kenji Yamada, Sooyoung Lee, Hikaru Kanemasa, Yoshitomo Motomura i in. "Diagnostic potential of stored dried blood spots for inborn errors of metabolism: a metabolic autopsy of medium-chain acyl-CoA dehydrogenase deficiency". Journal of Clinical Pathology 71, nr 10 (2.05.2018): 885–89. http://dx.doi.org/10.1136/jclinpath-2017-204962.
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AimIt is estimated that 1–5% of sudden infant death syndrome (SIDS) cases might be caused by undiagnosed inborn errors of metabolism (IEMs); however, the postmortem identification of IEMs remains difficult. This study aimed to evaluate the usefulness of dried blood spots (DBSs) stored after newborn screening tests as a metabolic autopsy to determine the causes of death in infants and children who died suddenly and unexpectedly.MethodsInfants or toddlers who had suddenly died without a definite diagnosis between July 2008 and December 2012 at Kyushu University Hospital in Japan were enrolled in this study. Their Guthrie cards, which had been stored for several years at 4–8°C, were used for an acylcarnitine analysis by tandem mass spectrometry to identify inborn errors of metabolism.ResultsFifteen infants and children who died at less than 2 years of age and for whom the cause of death was unknown were enrolled for the study. After correcting the C0 and C8 values assuming the hydrolysation of acylcarnitine in the stored DBSs, the corrected C8 value of one case just exceeded the cut-off level for medium-chain acyl-CoA dehydrogenase (MCAD) deficiency screening. Genetic and biochemical analyses confirmed this patient to have MCAD deficiency.ConclusionDBSs stored after newborn screening tests are a promising tool for metabolic autopsy. The appropriate compensation of acylcarnitine data and subsequent genetic and biochemical analyses are essential for the postmortem diagnosis of inborn errors of metabolism.
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Klyukhina, Yuliya Borisovna, Lyudmila Aleksandrovna Zhelenina i Dmitriy Olegovich Ivanov. "Pulmonary Catamnesis in Children on Artificial Lung Ventilation in the Neonatal Period". Pediatrician (St. Petersburg) 5, nr 3 (15.09.2014): 16–21. http://dx.doi.org/10.17816/ped5316-21.
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Bronchopulmonary pathology is the most frequent cause of morbidity and mortality among newborn infants. Emergency aid and inten-sive care to newborn infants decrease death rate among children; at the same time, they cause an increase in pulmonary morbidity. The article deals with data concerning generation of bronchopulmonary diseases in children who underwent resuscitation in neonatal period, tracks pulmonary catamnesis, and analyzes hereditary load. The article confirms the adverse effect of artificial lung ventilation on lungs of both mature and premature babies. Neonatal pneumonia, together with iatrogenic factors of emergency care, is a dominating factor in formation of chronic non-specific pulmonary diseases in catamnesis.
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Skene, Loane. "Legal Issues in Treating Critically Ill Newborn Infants". Cambridge Quarterly of Healthcare Ethics 2, nr 3 (1993): 295–308. http://dx.doi.org/10.1017/s0963180100004308.
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Say an infant is born with high lesion spina bifida. She is paralyzed from the waist down and has severe wasting of all areas below the waist. She will always be doubly incontinent and will have no normal sexual function. She has hydrocephalus and a brain stem, abnormality (Arnold Chiari malformation) that is likely to significantly shorten her life. She will probably be retarded and epileptic. She has severe leg deformities — dislocated hips, dislocated knees, and club feet. Her hips are held in a constant position over her chest and her knees cannot be bent in the right direction. She has an 80% chance of developing kyphoscoliosis (curvature of the spine) which may ultimately prevent her from, sitting in a wheelchair and may restrict her lungs, causing respiratory failure and death. She has little spontaneous movement and little response to simple stimuli. She has shallow breathing and difficulty in swallowing and sucking. Whatever treatment this infant is offered, she may not survive. If she does survive, her quality of life is likely to be so poor that one might question whether she would want to live such a life.
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Carrier, Jessica, i Vivian Haughton. "Congenital Syphilis: A Challenging Case for NICU Clinicians". Neonatal Network 38, nr 3 (1.05.2019): 170–77. http://dx.doi.org/10.1891/0730-0832.38.3.170.
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Congenital syphilis (CS) has been consistently on the rise in the United States since 2012, despite long-standing recommendations for routine testing and treatment of pregnant women. CS is associated with miscarriage, stillbirth, early infant death, and organ dysfunction in the newborn. Prevention is the optimal goal; however, early identification of infected infants is imperative to reduce the risk of serious, long-term complications. Clinicians must possess adequate knowledge of CS and the potentially life-threatening conditions that can arise to provide immediate and effective care. This case study portrays the clinical presentation of an infant with CS and the management of the multisystem effects of the disease.
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Kommawar, Ankush, Rajendra Borkar, Jayant Vagha, Bhavana Lakhkar, Rewat Meshram i Amar Taksandae. "Study of respiratory distress in newborn". International Journal of Contemporary Pediatrics 4, nr 2 (22.02.2017): 490. http://dx.doi.org/10.18203/2349-3291.ijcp20170695.
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Background: Respiratory distress is one of the most common reasons an infant is admitted to the neonatal intensive care unit. Fifteen percent of term infants and 29% of late preterm infants admitted to the neonatal intensive care unit develop significant respiratory morbidity; this is even higher for infants born before 34 weeks ‘gestation. Certain risk factors increase the likelihood of neonatal respiratory disease. These factors include prematurity, meconium-stained amniotic fluid (MSAF), caesarean section delivery, gestational diabetes, maternal chorioamnionitis, or prenatal ultrasonographic findings, such as oligohydramnios or structural lung abnormalities. Aim of the study was to study the, etiology and outcome of respiratory distress in newborns.Methods: The present study was conducted at the Department of Pediatrics, Acharya Vinoba Bhave Rural Hospital, Jawaharlal Nehru Medical College, Sawangi (Meghe),Wardha, Maharashtra, India. Sample size was decided on the basis of prevalence of neonatal respiratory distress in our area. It was conducted for a period of two years from 1st August 2014 to 31st July 2016.Results: maximum admissions on day 1 of life i.e. 309 (77.25%) followed by on day 2 i.e. 90 (22.50%) 231 (57.75%) were males and 169 (42.25%) were females. Male to female ratio was 1.36:1 Out of 400 children 11 were less than 1000 gms, followed by 77 (19.25%) had birth weight between 1000 g - 1499 g, 193 (48.25%) neonates had weight between 1500 g - 2499 gms and 118 (29.5%) neonates had weight between 2500 - 3499 gms and remaining 1 neonate had birth weight > 3500 grams. Out of 400 Neonates with respiratory distress, 281 (70.25%) had low birth weight and remaining 119 (29.75%) neonates had normal birth weight.Conclusions: Respiratory distress was the major cause of admission in our NICU. Caesarean section was the most common predisposing factor associated with the development of respiratory distress in neonates. Antenatal risk factors increase the incidence of RD. The most common causes of respiratory distress were TTN, RDS, MAS, and perinatal asphyxia. The common cause of death was HMD. The outcome of neonatal respiratory distress was found as: a survival rate of 78.5%, mortality rate of 21.5%.
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Pols, T., L. S. de Vries, A. Salamon, P. G. J. Nikkels, K. D. Lichtenbelt, S. M. Mulder-de Tollenaer i G. van Wezel-Meijler. "Symmetrical Thalamic Lesions in the Newborn: A Case Series". Neuropediatrics 50, nr 03 (26.03.2019): 152–59. http://dx.doi.org/10.1055/s-0039-1683864.
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AbstractAlthough bilateral injury to the thalami is often seen in (near)term infants with hypoxic ischemic encephalopathy (HIE), symmetrical thalamic lesions (STL) is a different, very rare condition, seen both in full-term and preterm infants often after an antenatal insult, although the history is not always clear. These lesions are usually first detected using cranial ultrasound (cUS). They may not always be seen on the first (admission) scan, but become apparent in the course of the 1st week after birth. Clinically, these infants present with hypo- or hypertonia, absence of sucking and swallowing reflexes, and they may have contractures and facial diplegia. Neuropathology commonly demonstrates a thalamic lesion with additional and variable involvement of basal ganglia and brainstem. The prognosis is very poor, the condition often leads to severe disabilities and/or death within the first years of life. The clinical course and neuroimaging findings of 13 patients with symmetrical thalamic lesions (STL) are reported.
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Ortigosa Rocha, Cristiane, Roberto Eduardo Bittar i Marcelo Zugaib. "Neonatal Outcomes of Late-Preterm Birth Associated or Not with Intrauterine Growth Restriction". Obstetrics and Gynecology International 2010 (2010): 1–5. http://dx.doi.org/10.1155/2010/231842.
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Objective. To compare neonatal morbidity and mortality between late-preterm intrauterine growth-restricted (IUGR) and appropriate-for-gestational-age (AGA) infants of the comparable gestational ages (GAs).Methods. We retrospectively analyzed neonatal morbidity and mortality of 50 singleton pregnancies involving fetuses with IUGR delivered between 34 and 36 6/7 weeks of GA due to maternal and/or fetal indication. The control group consisted of 36 singleton pregnancies with spontaneous preterm delivery at the same GA, in which the infant was AGA. Categorical data were compared between IUGR and AGA pregnancies by analysis and Fisher's exact test. Ordinal measures were compared using the Kruskal-Wallis test.Results. The length of stay of newborns in the nursery, as well as the need for and duration of hospitalization in the neonatal intensive care unit, was longer in the group with IUGR. Transient tachypnea of the newborn or apnea rates did not differ significantly between the IUGR and AGA groups. IUGR infants were found to be at a higher risk of intraventricular hemorrhage. No respiratory distress syndrome, pulmonary hemorrhage or bronchopulmonary dysplasia was observed in either group. The frequency of sepsis, thrombocytopenia and hyperbilirubinemia was similar in the two groups. Hypoglycemia was more frequent in the IUGR group. No neonatal death was observed.Conclusion. Our study showed that late-preterm IUGR infants present a significantly higher risk of neonatal complications when compared to late-preterm AGA infants.
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Delaney, Meghan, i Dana C. Matthews. "Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn". Hematology 2015, nr 1 (5.12.2015): 146–51. http://dx.doi.org/10.1182/asheducation-2015.1.146.
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AbstractHemolytic disease of the fetus and newborn (HDFN) affects 3/100 000 to 80/100 000 patients per year. It is due to maternal blood group antibodies that cause fetal red cell destruction and in some cases, marrow suppression. This process leads to fetal anemia, and in severe cases can progress to edema, ascites, heart failure, and death. Infants affected with HDFN can have hyperbilirubinemia in the acute phase and hyporegenerative anemia for weeks to months after birth. The diagnosis and management of pregnant women with HDFN is based on laboratory and radiographic monitoring. Fetuses with marked anemia may require intervention with intrauterine transfusion. HDFN due to RhD can be prevented by RhIg administration. Prevention for other causal blood group specificities is less studied.
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Gong, Alice, Judith Livingston, Liza Creel, Elena Ocampo, Tiffany McKee-Garrett i Charleta Guillory. "Texas Pulse Oximetry Project: A Multicenter Educational and Quality Improvement Project for Implementation of Critical Congenital Heart Disease Screening Using Pulse Oximetry". American Journal of Perinatology 34, nr 09 (6.03.2017): 856–60. http://dx.doi.org/10.1055/s-0037-1599214.
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Objective Critical congenital heart disease (CCHD) is a leading cause of death in infants. Newborn screening (NBS) by pulse oximetry allows early identification of CCHD in asymptomatic newborns. To improve readiness of hospital neonatal birthing facilities for mandatory screening in Texas, an educational and quality improvement (QI) project was piloted to identify an implementation strategy for CCHD NBS in a range of birthing hospitals. Study Design Thirteen Texas hospitals implemented standardized CCHD screening by pulse oximetry. An educational program was devised and a tool kit was created to facilitate education and implementation. Newborn nursery nurses' knowledge was assessed using a pre- and posttest instrument. Results The nurses' knowledge assessment improved from 71 to 92.5% (p < 0.0001). Of 11,322 asymptomatic newborns screened after 24 hours of age, 11 had a positive screen, with 1 confirmed case of CCHD. Pulse oximetry CCHD NBS had sensitivity of 100%, specificity of 99.91%, false-positive rate of 0.088%, positive predictive value of 9.09%, and negative predictive value of 100%. Conclusion Our educational program, including a tool kit, QI processes, and standardized pulse oximetry CCHD NBS, is applicable for a range of hospital birthing facilities and may facilitate wide-scale implementation, thereby improving newborn health.
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Muramatsu, Hideki, Daiei Kojima, Yusuke Okuno, Shinsuke Kataoka, Yoko Nakajima, Tetsuya Ito, Ikuya Tsuge i in. "Combination of TREC Measurement and Next-Generation Sequencing in Newborn Screening for Severe Combined Immunodeficiency: A Pilot Program in Japan". Blood 132, Supplement 1 (29.11.2018): 3717. http://dx.doi.org/10.1182/blood-2018-99-118261.
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Abstract INTRODUCTION Severe combined immunodeficiency disease (SCID) is the most severe form of primary immunodeficiency disorders (PIDs). Impaired cellular and humoral immunity renders the affected infants susceptible to various infections and results in death within the first 2 years of life. Affected infants are asymptomatic at birth, untreated disease leads to death, and prompt treatment (i.e., hematopoietic stem cell transplantation, gene therapy, or enzyme replacement therapy) is linked to significant improvement in outcome. Thus, SCID meets the disease criteria for newborn screening (NBS). The T-cell receptor excision circle (TREC) is an excellent marker of recently formed T cells, and quantitative PCR-based measurement of TREC is an excellent tool in population-based NBS for SCID. Recent progress in next-generation sequencing (NGS) has enabled the simultaneous sequencing of numerous nucleic acids, detecting single nucleotide changes as well as copy number variants. We launched a pilot newborn optional screening program for SCID, combining the measurement of TREC and NGS in Japan. PATIENTS AND METHODS We measured TREC copy number using the Enlite™ Neonatal TREC assay (Perkin Elmer, Turku, Finland), which utilizes the duplex amplification of TREC and beta-actin in the same reaction for each specimen. We used TREC negative cutoffs as follows: TREC copy number of <30 copies/μL and beta-actin copy number of ≥50 copies/μL. In patients with TREC negative results, genomic DNA was subjected to DNA capture designed using SureDesign (Agilent, Santa Clara, USA), covering a total of 349 genes associated with PIDs, inherited bone marrow failure syndromes, and the 22q11.2 region. Target capture, enrichment, and indexing were performed according to the manufacturer's instructions. Generated libraries were sequenced using a HiSeq 2500 platform (Illumina, San Diego, USA). This study was approved by the ethical committees of the Nagoya University Graduate School of Medicine and Fujita Health University. RESULTS From April 2017 to March 2018, we screened a total of 22,865 newborns, covering 57% of the total number of births in the Aichi prefecture, Japan. We identified 48 (0.21%) newborns with TREC negative results. These newborns were referred to the Nagoya University Hospital or Fujita Health University Hospital and received thorough immunological examination, including target capture sequencing. Among them, 12 (25%) newborns had background diseases, including Down syndrome (n = 4), gastrointestinal defects (n = 3), congenital diaphragmatic hernia (n = 2), congenital chylothorax (n = 2), and severe congenital heart anomaly (n = 1). Immunological assessment identified 11 (23%) infants with lymphocytopenia (<1500 /μL). These infants avoided live vaccines and received appropriate interventions to prevent infection. Using target sequencing analyses, we identified four patients with PIDs, including 22q11.2 deletion syndrome (n = 2), Wiskott‒Aldrich syndrome (n = 1), and combined immunodeficiency with an unknown causative gene (n = 1). CONCLUSION We successfully launched a pilot newborn optional screening program for SCID, combining the measurement of TREC and NGS in Japan. We did not identify typical SCID patients probably because of the relatively small sample size. However, this newborn screening program, incorporating an NGS assay as a second test, achieved early accurate diagnoses of patients with other PIDs with TREC negative results. Consequently, this program may facilitate patient management and optimize treatment outcomes. Disclosures No relevant conflicts of interest to declare.
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Rodrigues, Larissa, Daniela Danttas Lima, Juliana Vasconcelos Freitas de Jesus, Gabriel Lavorato Neto, Egberto Ribeiro Turato i Claudinei José Gomes Campos. "Understanding bereavement experiences of mothers facing the loss of newborn infants". Revista Brasileira de Saúde Materno Infantil 20, nr 1 (marzec 2020): 65–72. http://dx.doi.org/10.1590/1806-93042020000100005.
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Abstract Objective: to understand mothers' bereavement experiences regarding the loss of their newborn child in the Neonatal Intensive Care Unit of a Brazilian university hospital. Methods: the study was designed by the clinical-qualitative method to understand the meaning of the emerging relationships of health scenarios. Sample consisted of six mothers. The sufficiency of the sample was verified through the saturation of the data. The data collection instrument was a semistructured interview with script of open questions, the collected material was recorded and transcribed in full. Thematic analysis was performed by two independent authors. Results: feelings and perceptions of the grieving process gave rise to three categories: 1. Guilt and fantasy of bereavement related to the death and grief for their children; 2. Relationships and ambiguities - the relationship between internal concerns and perception of external relations; 3. Fear, disbelief, abandonment and loneliness - questions about perception of the external environment. Conclusions: mothers' bereavement experience is mainly permeated by loneliness and abandonment related to feelings of guilt for not being able to keep their children alive. The difficult and definitive separation in the postpartum period, caused by death, brings fantasies of reunion with their child. Women show the need to realize grief, especially by recognizing their baby's identity.
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Serdarevich, Christine, i James E. Fewell. "Influence of core temperature on autoresuscitation during repeated exposure to hypoxia in normal rat pups". Journal of Applied Physiology 87, nr 4 (1.10.1999): 1346–53. http://dx.doi.org/10.1152/jappl.1999.87.4.1346.
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Failure to autoresuscitate by hypoxic gasping during prolonged sleep apnea has been suggested to play a role in sudden infant death. Furthermore, thermal stress brought about by a contribution of infection, overwrapping, or excessive environmental heating has been shown to be associated with an increased risk of sudden infant death, particularly in prone sleeping infants. The present experiments were carried out on newborn rat pups to investigate the influence of “forced” changes in core temperature on their time to last gasp during a single hypoxic exposure and on their ability to autoresuscitate during repeated exposure to hypoxia. On day 5 or 6 postpartum the pups were placed in a temperature-controlled chamber regulated to 33, 35, 37, 39, or 41°C and exposed to a single period of hypoxia (97% N2-3% CO2) and their time to last gasp was determined, or they were exposed repeatedly to hypoxia and their ability to autoresuscitate from primary apnea was determined. Increases in core temperature brought about by changes in ambient temperature from 33 to 41°C decreased the time to last gasp after a single hypoxic exposure and decreased the number of successful autoresuscitations after repeated hypoxic exposures. Thus our data support the hypothesis that forced changes in core temperature brought about by changes in ambient temperature influence protective responses in newborns that may prevent death during hypoxia, as may occur during single or repeated episodes of prolonged sleep apnea.
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Kooi, E. MW. "Current insights in brain protection for the sick newborn infant". Pediatrician (St. Petersburg) 6, nr 1 (15.03.2015): 22–28. http://dx.doi.org/10.17816/ped6122-28.
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This paper presents an overview of the modern antenatal and postnatal strategies in brain protection for both preterm and term born infants. It is known, that the two most common causes of neonatal brain injury are prematurity and hypoxic-ischemic encephalopathy (HIE) in the term born infant. Approximately one in nine babies is born before term. Nowadays these preterm born infants more often survive the neonatal period due to developments in treatment options in the last decades. They are however at a high risk for developing brain damage and neurodevelopmental impairment later in life. Approximately 40 % of survivors develop long-term intellectual or physical impairment, including cerebral palsy (CP). Term born infants born after perinatal asphyxia may also survive with a variety of neurocognitive disorders due to brain damage as a result from the hypoxic ischemic encephalopathy (HIE). Untreated, the sequelae of moderate to severe HIE includes a 60 to 65 % risk of mental retardation, CP, hydrocephalus, seizures, or death. The main goal in neonatal care for these surviving but vulnerable infants is to preserve brain function and prevent further brain damage, in order to improve neurocognitive outcome and the subsequent quality of life. In preterm brain protection antenatal strategies besides educating and supporting pregnant women regarding life style and healthy food intake, centralization of care for extreme preterm born infants, fetal monitoring in high risk pregnancies, administration of antenatal steroids for lung maturity, the use of intravenous magnesium sulfate administration to mothers just before preterm delivery are of great importance. In the postnatal strategies setting optimal oxygen saturation, the avoidance of prolonged artificial mechanical ventilation, hypoglycemia, hypocapnia electrolytic imbalances, hyperbilirubinemia, blood pressure shifts, stress and pain, inflammation, necrotizing enterocolitis as well as adequate feeding strongly predict neurocognitive outcome. In the term asphyxiated infants the brain experiences a cascade of problems occurring after energy failure which in fact are the basis of neuroprotective strategies. These strategies consist of anti-oxidative, anti-inflammatory, anti-excitatoxic and anti-apoptotic agents, and in the future possibly neurogenetic approaches, including stem cell therapy. In antenatal strategies prevention of asphyxia starts at promoting a healthy pregnancy and of an early recognition of fetal, placental or perinatal risk factors for hypoxia. Recent experimental trials have shown a possible beneficial effect of antenatal administration of the anti-oxidative agent allopurinol in a HIE. In postnatal strategies two methods to achieve therapeutic hypothermia were evaluated in newborn infants with HIE: whole body cooling and selective head cooling with mild systemic hypothermia with the conclusion: hypothermia should be instituted in term infants with moderate-to-severe hypoxic ischemic encephalopathy if identified before six hours of age. Monitoring of brain activity by means of amplitude integrated electroencephalography to identify infants with HIE is promising. Potential agents with either anti-oxidative, anti-inflammatory, anti-excitatoxic or anti-apoptotic capacities are currently being investigated in various phases of research.
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Pratiwi, I. G. A. P. Eka, Soetjiningsih Soetjiningsih i I. Made Kardana. "Effect of kangaroo method on the risk of hypothermia and duration of birth weight regain in low birth weight infants: A randomized controlled trial". Paediatrica Indonesiana 49, nr 5 (31.10.2009): 253. http://dx.doi.org/10.14238/pi49.5.2009.253-8.
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Background In Indonesia, the infant mortality rate in 2001 was 50 per 1000 live births, with 34.7% due to perinatal death. This perinatal death was associated with low birth weight (LBW) newborn, which was caused by prematurity, infection, birth asphyxia, hypothermia, and inadequate breast feeding. In developing countries, lack of facilities of LBW infant care leads to the utilization of kangaroo method as care to prevent hypothermia in LBW newborn.Objective To evaluate the differences of hypothermia event andduration of birth weight regain in LBW newborns between earlykangaroo care (EKC) and conventional care (CC).Methods This was an open label randomized controlled trial. The1500-2250 g LBW newborns who were born in Sanglah Hospitalwere randomized to EKC and CC groups.Results Hypothermia events were found more often in CC groupthan EKC group (RR=0.645, 90% CI 0.45 to 0.92, P=0.05). Thisdifference was influenced by breast feeding frequency. Duration of birth weight regain in EKC group (median 5 days (SE=0.31, 90% CI 4.49 to 5.51) was shorter than CC group (median 6 days (SE=0.52, 90% CI 5.15 to 6.85), but this difference wasn't statistically significant (P=0.40). Percentage of birth weight decrease, breastfeeding frequency, and hyperbilirubinemia events that needed phototheraphy were associated with the duration of birth weight increase.Conclusion EKC helps to decrease the incidence of hypothermiaevents, but fails to shorten duration of birth weight increase.Percentage of birth weight decrease, breast-feeding frequency, and hyperbilirunemia events that need phototheraphy are associated with the duration of birth weight increase in LBW newborn.
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Kumar, Praveen. "Universal Pulse Oximetry Screening for Early Detection of Critical Congenital Heart Disease". Clinical Medicine Insights: Pediatrics 10 (styczeń 2016): CMPed.S33086. http://dx.doi.org/10.4137/cmped.s33086.
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Critical congenital heart disease (CCHD) is a major cause of infant death and morbidity worldwide. An early diagnosis and timely intervention can significantly reduce the likelihood of an adverse outcome. However, studies from the United States and other developed countries have shown that as many as 30%–50% of infants with CCHD are discharged after birth without being identified. This diagnostic gap is likely to be even higher in low-resource countries. Several large randomized trials have shown that the use of universal pulse-oximetry screening (POS) at the time of discharge from birth hospital can help in early diagnosis of these infants. The objective of this review is to share data to show that the use of POS for early detection of CCHD meets the criteria necessary for inclusion to the universal newborn screening panel and could be adopted worldwide.
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Utomo, Martono Tri. "Neonatal Sepsis in Low Birth Weight Infants in Dr. Soetomo General Hospital". Indonesian Journal of Tropical and Infectious Disease 1, nr 2 (3.05.2010): 86. http://dx.doi.org/10.20473/ijtid.v1i2.2172.
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Infections of the newborn are a significant cause of mortality. Preterm infant have a high risk sepsis.. The incidence of neonatal sepsis is 1 to 10 cases per 1000 live births and 1 per 250 live premature births. To describe the characteristics of neonatal sepsis in the low birth weight infant in the neonatal intensive care unit Dr. Soetomo Hospital. Retrospective analysis. The data were collected from the medical record of low birth weight infants who were diagnosed as sepsis in neonatal care unit of Dr. Soetomo Hospital between January 2010 to June 2010 with purposive sampling. Descriptive analysis of risk factor of sepsis and blood culture of the patient was calculated. Chi-square analysis was performed in the laboratorium data. Characteristics sample: male vs female 61% vs 39%, outcome of sepsis in LBW was death 69%, alive 25%, risk of infection: turbid amniotic fluid 21%, asphyxia 33%. Laboratorium data leucopenia and thrombocytopenia (P < 0.05). Blood culture: Klebsiella pnemoniae. The incidence and mortality of neonatal sepsis in LBW infants was still high. Asphyxia, turbid amniotic fluid, leucopenia and thrombocytopenia were associated with sepsis. pneumoniae was the most common organisms in the LBW sepsis infants.
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Goberman, Alexander M., i Jason A. Whitfield. "Acoustics of Infant Pain Cries: Fundamental Frequency as a Measure of Arousal". Perspectives on Speech Science and Orofacial Disorders 23, nr 1 (lipiec 2013): 18–26. http://dx.doi.org/10.1044/ssod23.1.18.
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Purpose: The goal of the current study is to examine fundamental frequency (F0) from a sample of healthy newborn infant pain cries. Methods: A total of 58 healthy infants were included in the study. Data were examined from the first cry following a pain stimulus, in addition to a comparison of the first 30 seconds and the last 30 seconds of the entire crying episode. Results: In the current study, the mean F0 was found to decrease over time (regardless of infant sex, term status, or positioning). The data also showed a significantly higher F0 for preterm female infants (compared to preterm males) in the first cry immediately following the pain stimulus. Conclusions: These results reflect high levels of laryngeal tension following the pain stimulus, followed by an overall decrease in tension /arousal over time. The results support examination of the first cry following a pain stimulus, along with examination of the entire cry episode. Implications for the study of arousal and sudden infant death syndrome are discussed.
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Köstlin-Gille, Natascha, Lara-Antonia Flaig, Marco Ginzel, Jörg Arand, Christian F. Poets i Christian Gille. "Granulocytic Myeloid-Derived Suppressor Cells in Breast Milk (BM-MDSC) Correlate with Gestational Age and Postnatal Age and Are Influenced by Infant’s Sex". Nutrients 12, nr 9 (25.08.2020): 2571. http://dx.doi.org/10.3390/nu12092571.
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Background: Infections are the main cause of death in preterm infants. Causative agents often descend from the intestinal flora of the infected neonate, indicating insufficient protection by the mucosal barrier. Breast milk (BM) contains different subsets of immune cells. We recently showed that BM contains significant numbers of myeloid-derived suppressor cells (MDSC)—immune cells that actively suppress pro-inflammatory immune responses—and hypothesized that the transfer of BM-MDSC may modulate the mucosal immunity of the newborn. Methods: Percentages of MDSC in the BM from mothers of 86 preterm infants between 23 + 0 and 36 + 6 weeks of gestation during their first five postnatal weeks were analyzed by flow cytometry and correlated with maternal and infant characteristics. Results: Percentages of BM-MDSC positively correlated with gestational age and postnatal age. The expression of activation markers on BM-MDSC did not change with gestational age, but it decreased with postnatal age. Mothers who received antepartum tocolytics had lower percentages of BM-MDSC, and infant’s sex strongly influenced percentages of BM-MDSC. Conclusion: Our results point toward a role of BM-MDSC for immune regulation in the neonatal gut, making them a potential target of immune-based therapies shortly after birth.
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Aleksi-Meskhishvili, V. V., i Yury A. Kozlov. "SURGICAL TREATMENT OF OPEN DUCTUS ARTERIOSUS IN PREMATURE INFANTS". Russian Journal of Pediatric Surgery 22, nr 3 (16.08.2018): 148–54. http://dx.doi.org/10.18821/1560-9510-2018-22-3-148-154.
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The open arterial duct (OAD) means the maintenance of the OAD patency in the postnatal period within 48-72 hours after birth. OAD in preterm infants is of particular importance and often determines their survival. The presence of OAD significantly reduces chances of premature babies to recover, as it contributes to the emergence and aggravation of diseases such as necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), renal dysfunction, intraventricular hemorrhage (IVH), cerebral palsy and, often, the death of a newborn. From this point of view, there is appeared the importance of diagnosis and treatment of OAD in premature newborns to improve the prognosis of life in this category of patients. Until today, there is no generally accepted strategy for treating OAD in premature infants. As a result, in various neonatal centers, even within the same country, doctors adhere to different tactics in the treatment of OAD in premature infants. Surgical correction of the hemodynamically significant OAP is indicated for premature infants dependent on artificial ventilation of the lungs, with lack of the effect of the drug therapy or inability to introduce medication. In this scientific review, 3 technologies of surgical treatment of OAD are discussed: open surgery, thoracoscopy, and endovascular treatment. Special attention is paid to postoperative management of patients and prevention of complications.
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Reynolds, E. Osmund R. "New Noninvasive Techniques for Assessing Brain Oxygenation and Hemodynamics". International Journal of Technology Assessment in Health Care 7, S1 (styczeń 1991): 125–27. http://dx.doi.org/10.1017/s0266462300012642.
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Infants who require intensive care are at considerable risk of death or long-term neurodevelopmental disability. Therefore, noninvasive methods have been sought for assessing the structure and function of the brain in the immediate newborn period. The major aims are to investigate the prevalence and mechanisms of brain-damaging lesions, to test preventive strategies and treatment, and to assign the prognosis of the infants. Several methods have proved their worth, e.g., ultrasound imaging, electroencephalography, including the testing of evoked potentials, and Doppler ultrasonography for measuring flow velocity in intracerebral vessels.
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Samudro, Heru, i Mulyadi M. Djer. "Inhaled iloprost as part of combination therapy for persistent pulmonary hypertension of the newborn". Paediatrica Indonesiana 52, nr 1 (3.03.2012): 57. http://dx.doi.org/10.14238/pi52.1.2012.57-60.
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Persistent pulmonary hypertension of thenewborn (PPHN) is rare, but life-threatening.If not treated, PPHN may cause respiratoryfailure and death in neonates. l,2,3 PPHNoften occurs in term or post-term infants with a historyof difficult labor, infection or asphyxia during birth.These infants do not have adequate oxygen duringlabor.3 Based on etiology, PPHN can be categorizedinto primary PPHN, which occurs by itself withoutapparent cause; or secondary PPHN, which is causedby meconium aspiration, hyaline membrane disease,neonatal sepsis with pneumonia, congenital heartabnormality, or maternal drug use (non-steroidalanti-inflammatories, methamphetamine, or selectiveserotonin re uptake inhibitors) during the thirdtrimester of pregnancy.
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Heere, Megan, Beth Moughan, Joseph Alfonsi, Jennifer Rodriguez i Stephen Aronoff. "Effect of Education and Cardboard Bassinet Distribution on Newborn Bed-Sharing". Global Pediatric Health 6 (styczeń 2019): 2333794X1982917. http://dx.doi.org/10.1177/2333794x19829173.
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Objective. This study sought to determine if infant sleep education plus a cardboard bassinet reduced bed-sharing, a risk factor for sudden infant death syndrome (SIDS) and sleep-related deaths (SRD), in the first week of life. Methods. Women delivered between 1/1/2015-11/15/2016 were interviewed by phone within 72 hours of discharge. Control 1 delivered through 10/31/2015 (previously reported); Control 2: 11/1/2015-2/7/2016; Intervention 1 received inpatient safe sleep education and delivered between 2/8/2016-5/4/2016; Intervention 2 also received a cardboard bassinet and delivered after 5/4/2016. Subjects self-reported bed-sharing, newborn sleep position, feeding method, and sleep environment; demographic data was obtained from medical records. Bayesian methodology compared bed-sharing rates between aggregated control and intervention groups; results were expressed as posterior rates, rate ratios, and 95% credible intervals (CredInt); the posterior probability that the rate ratio was > 1(Bayesian probability) was determined by calculation and simulation. Results. 5187 eligible subjects, 2763 (53%) completed the survey (Control 1: n=1264; Control 2: n=423; Intervention 1: n=391; Intervention 2: n=685). Bed-sharing rates: Control: 6.3% (5.2,7.4); Intervention: 4.7% (3.5,5.9). Rate ratio (Control/Intervention) was 1.36 (0.95,1.83) and the Bayesian probability that the rate ratio >1 was .96 and .97 by calculation and simulation, respectively. Bed-sharing rates for exclusively breastfed infants: Control: 11% (7.4, 14.6); Intervention: 5.9% (2.7, 9.2); Rate ratio was 2.00 (1.01, 3.15) and the Bayesian probability that the rate ratio >1 was .993. Conclusions. Infant sleep education plus a cardboard bassinet reduced the rate of bed-sharing in the first week of life, particularly among exclusively breastfeeding dyads.
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Petousis-Harris, Helen, Yannan Jiang, Lennex Yu, Donna Watson, Tony Walls, Nikki Turner, Anna S. Howe i Jennifer B. Griffin. "A Retrospective Cohort Study of Safety Outcomes in New Zealand Infants Exposed to Tdap Vaccine in Utero". Vaccines 7, nr 4 (11.10.2019): 147. http://dx.doi.org/10.3390/vaccines7040147.
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We aimed to evaluate the safety of maternal Tdap; thus, we assessed health events by examining the difference in birth and hospital-related outcomes of infants with and without fetal exposure to Tdap. This was a retrospective cohort study using linked administrative datasets. The study population were all live-born infants in New Zealand (NZ) weighing at least 400 g at delivery and born to women who were eligible for the government funded, national-level vaccination program in 2013. Infants were followed from birth up to one year of age. There were a total of 69,389 eligible infants in the cohort. Of these, 8299 infants were born to 8178 mothers exposed to Tdap (12%), primarily between 28 and 38 weeks gestation as per the national schedule. Among the outcomes, we found a reduced risk for moderate to late preterm birth, low birth weight, small for gestational age, large for gestational age, respiratory distress syndrome, transient tachypnea of newborn, tachycardia or bradycardia, haemolytic diseases, other neonatal jaundice, anaemia, syndrome of infant of mother with gestational diabetes, and hypoglycemia in infants born to vaccinated mothers. There was no association between maternal Tdap, infant Apgar score at 5 min after birth, asphyxia, sepsis or infection, or hypoxic ischemic encephalopathy. Infant exposure to Tdap during pregnancy was associated with a higher mean birthweight (not clinically significant) and higher odds for ankyloglossia and neonatal erythema toxicum diagnoses. There were insufficient observations to allow examination of the effect of Tdap on extreme preterm and very preterm birth, and stillbirth, infant death, or microcephaly. Overall, we found no outcomes of concern associated with the administration of Tdap during pregnancy. NZ Health and Disability Ethics Committee Approval #14/N.T.A/169/AM05.
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Magalhães, Mauricio, Francisco Paulo Martins Rodrigues, Maria Renata Tollio Chopard, Victoria Catarina de Albuquerque Melo, Amanda Melhado, Inez Oliveira, Clery Bernardi Gallacci, Paulo Roberto Pachi i Tabajara Barbosa Lima Neto. "Neuroprotective body hypothermia among newborns with hypoxic ischemic encephalopathy: three-year experience in a tertiary university hospital. A retrospective observational study". Sao Paulo Medical Journal 133, nr 4 (28.10.2014): 314–19. http://dx.doi.org/10.1590/1516-3180.2013.7740026.
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CONTEXT AND OBJECTIVE:Neonatal hypoxic-ischemic encephalopathy is associated with high morbidity and mortality. Studies have shown that therapeutic hypothermia decreases neurological sequelae and death. Our aim was therefore to report on a three-year experience of therapeutic hypothermia among asphyxiated newborns.DESIGN AND SETTING:Retrospective study, conducted in a university hospital.METHODS:Thirty-five patients with perinatal asphyxia undergoing body cooling between May 2009 and November 2012 were evaluated.RESULTS:Thirty-nine infants fulfilled the hypothermia protocol criteria. Four newborns were removed from study due to refractory septic shock, non-maintenance of temperature and severe coagulopathy. The median Apgar scores at 1 and 5 minutes were 2 and 5. The main complication was infection, diagnosed in seven mothers (20%) and 14 newborns (40%). Convulsions occurred in 15 infants (43%). Thirty-one patients (88.6%) required mechanical ventilation and 14 of them (45%) were extubated within 24 hours. The duration of mechanical ventilation among the others was 7.7 days. The cooling protocol was started 1.8 hours after birth. All patients showed elevated levels of creatine phosphokinase, creatine phosphokinase- MB and lactate dehydrogenase. There was no severe arrhythmia; one newborn (2.9%) presented controlled coagulopathy. Four patients (11.4%) presented controlled hypotension. Twenty-nine patients (82.9%) underwent cerebral ultrasonography and 10 of them (34.5%) presented white matter hyper-echogenicity. Brain magnetic resonance imaging was performed on 33 infants (94.3%) and 11 of them (33.3%) presented hypoxic-ischemic changes. The hospital stay was 23 days. All newborns were discharged. Two patients (5.8%) needed gastrostomy.CONCLUSION:Hypothermia as therapy for asphyxiated newborns was shown to be safe.
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Sedin, Gunnar. "CPAP and Mechanical Ventilation". International Journal of Technology Assessment in Health Care 7, S1 (styczeń 1991): 31–40. http://dx.doi.org/10.1017/s0266462300012472.
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Respiratory insufficiency has previously been a frequent cause of neonatal death, especially in preterm infants. As late as in 1967, Silverman and associates (66) found that in infants with hyaline membrane disease (HMD), mechanical ventilation with a body-enclosing negative pressure respirator did not improve survival. Before 1970, the mortality among infants who required respiratory therapy was high (20;46;70). At the end of the 1960s and the beginning of the 1970s, several new methods were introduced to improve ventilation of newborn infants. Kirby and coworkers (41) introduced intermittent mandatory ventilation as a way of weaning from mechanical ventilation. In a series of studies, Reynolds and coworkers evaluated the effects of different peak airway pressures, respiratory frequencies, and inspiratory:expiratory ratios on arterial blood gases and right to left shunts (32;58;59;60).
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Znamenska, Тetiana, Оlha Vorobiova, Тetiana Holota, Yurii Marushko i Valerii Pokhylko. "THE IMPORTANCE OF CARNITINE AND ITS METABOLISM IN NEWBORN: LITERATURE REVIEW AND CLINICAL CASE". Emergency Medical Service 8, nr 2 (2021): 100–103. http://dx.doi.org/10.36740/emems202102107.
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Aim: To analyze the literature on the processes of formation of endogenous and exogenous carnitine, its metabolism and function in the newborn. Material and methods: The literature data and international clinical recommendations for pathological conditions leading to primary and secondary carnitine deficiency have been retrospectively analyzed. A clinical case of a child with suspected systemic carnitine deficiency is presented. Conclusions: Depending on the reasons that led to carnitine deficiency, there are primary and secondary carnitine deficiency. Primary carnitine deficiency is a rare condition that can lead to metabolic decompensation, muscular and cardiac myopathy, and sudden death. Secondary carnitine deficiency can be caused by a genetically determined congenital metabolic defect, insufficient substrate intake, acquired disorder, immaturity of the biochemical pathway in premature infants, renal failure or iatrogenic exposure. Familiarization with the main causes of carnitine deficiency in newborns will more effectively detect and correct the clinical manifestations of this condition.
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Vettukattil, Joseph J. "Target Oxygen Levels and Critical Care of the Newborn". Current Pediatric Reviews 16, nr 1 (9.04.2020): 2–5. http://dx.doi.org/10.2174/1573396315666191016094828.
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Despite our growing experience in the medical care of extremely preterm infants and critically ill neonates, there are serious gaps in the understanding and clinical application of the adaptive physiology of the newborn. Neonatal physiology is often misinterpreted and considered similar to that of adult physiology. The human psyche has been seriously influenced, both from an evolutionary and survival point of view, by the cause and effect of hypoxemia which is considered as a warning sign of impending death. Within this context, it is unimaginable for even the highly trained professionals to consider saturation as low as 65% as acceptable. However, all available data suggests that newborns can thrive in a hypoxemic environment as they are conditioned to withstand extreme low saturations in the fetal environment. An approach utilizing the benefits of the hypoxic conditioning would prompt the practice of optimal targeted oxygen saturation range in the clinical management of the newborn. Our current understanding of cyanotic congenital heart disease and the physiology of single ventricle circulation, where oxygen saturation in mid 70s is acceptable, is supported by clinical and animal studies. This article argues the need to challenge our current acceptable target oxygen saturation in the newborn and provides the reasoning behind accepting lower target oxygen levels in the critically ill newborn. Challenging the current practice is expected to open a debate paving the way to understand the risks of high target oxygen levels in the newborn compared with the benefits of permissive hypoxia in avoiding the associated morbidity and mortality of oxygen radical injury.
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Boucek Jr, Robert J., Mark M. Boucek i Alfred Asante-Korang. "Advances in methods for surveillance of rejection". Cardiology in the Young 14, S1 (luty 2004): 93–96. http://dx.doi.org/10.1017/s1047951104006377.
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Transplantation is an effective treatment modality for infants1 and children2 with end-stage cardiac diseases. Rejection remains a major complication (Figure 1), even in newborn infants.3 Acute rejection can best be operationally defined by clinical findings, histopathology, and/or abnormalities of ventricular function of new origin that require, and respond to, intensified immunosuppression. Mechanistically, the ability to detect acute rejection is critically dependent on the detection of significant new myocytic injury, damage, and/or death. Surveillance for rejection is critically important in determining both long and short-term outcomes following cardiac transplantation. The ideal strategy for surveillance should have a high negative predictive value, correctly identifying the absence of myocytic injury, with high specificity, such that it does not falsely predict such injury.4